Remote HCC Coding Specialist - Risk Adjustment & Audits

Highmark Health; Hydaburg (AK); Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Health is seeking a Remote HCC Coding Specialist to support risk adjustment coding for MA, ACA, and ESRD programs. You will code from diverse EMR systems, adhere to CMS guidelines, and contribute to RPM projects while maintaining accuracy and productivity.

Qualifications include CPC/CRC/CCS/RHIT and 3–5 years of HCC experience. Travel is variable; remote office-based position aligns with HIPAA and privacy policies.

Qualifications

• 3 years HCC coding and/or coding and billing
• 5 years HCC coding and/or coding and billing
• Required CPC, CRC, CCS, RHIT certifications

Responsibilities

• Performs HCC coding on projects for MA, ACA, and ESRD across various models.
• Assists with Regulatory Audits by performing first coding review and ranking of charts.
• Participates in ad-hoc projects to address department needs and improvements.
• Engages in RPM Coding educational meetings and annual coding Summit.
• Other duties as assigned.

Skills

Critical Thinking

Attention to Detail

Written and Oral Presentation Skills

Written Communications

Communication Skills

HCC Coding

MS Word, Excel, Outlook, PowerPoint

Microsoft Office Suite Proficient/ -  

MS365 & Teams

Education

CPC

CRC

CCS

RHIT

Tools

CMS Guidelines Software

EMR Systems

Job description

Highmark Health is seeking a Remote HCC Coding Specialist to support risk adjustment coding for MA, ACA, and ESRD programs. You will code from diverse EMR systems, adhere to CMS guidelines, and contribute to RPM projects while maintaining accuracy and productivity.

Qualifications include CPC/CRC/CCS/RHIT and 3–5 years of HCC experience. Travel is variable; remote office-based position aligns with HIPAA and privacy policies.